<div class="col-md-15">
    <form id="basicForm" action="" method="post" class="form-horizontal">
        <div class="panel panel-default">
            <div class="panel-heading">
                <div class="panel-btns">
                    <a href="" class="panel-close">&times;</a>
                    <a href="" class="minimize">&minus;</a>
                </div>
                <h4 class="panel-title">假期去向登记</h4>
                <p style="color: red;">务必认真填写，回家的需要写清楚回哪里。旅游的写清楚去哪里旅游，去玩的也得写清楚去哪玩。做兼职写清楚去哪做</p>
            </div>
            <div class="panel-body">
                <div class="form-group">
                    <label class="col-sm-3 control-label">学生名字 <span class="asterisk">*</span></label>
                    <div class="col-sm-9">
                        <input type="text" name="name" class="form-control" placeholder="请输入你的名字..." value="{$_SESSION['dataInfo']['name']}" required disabled/>
                    </div>
                </div>

                <div class="form-group">
                    <label class="col-sm-3 control-label">假期去向 <span class="asterisk">*</span></label>
                    <div class="col-sm-9">
                        <input type="text" name="address" class="form-control" placeholder="务必写清楚去哪回哪..." required minlength="4" value="{$upret.address}" />
                    </div>
                </div>

                <div class="form-group">
                    <label class="col-sm-3 control-label">联系人 <span class="asterisk">*</span></label>
                    <div class="col-sm-9">
                        <input type="text" name="contacts" class="form-control" placeholder="请输入联系人的名字..." required  value="{$upret.contacts}"/>
                    </div>
                </div>

                <div class="form-group">
                    <label class="col-sm-3 control-label">联系电话 <span class="asterisk">*</span></label>
                    <div class="col-sm-9">
                        <input type="number" name="tel" class="form-control" placeholder="请输入联系人的电话号码..." required  value="{$upret.tel}"/>
                    </div>
                </div>

                <div class="form-group">
                    <label class="col-sm-3 control-label">离校时间 <span class="asterisk">*</span></label>
                    <div class="col-sm-9">
                        <!--<input type="date" name="ltime" class="form-control" required  value="{$upret.ltime}"/>-->
                        <div class="input-group">
                            <input type="text" class="form-control" name="ltime" placeholder="yy-mm-dd 离校时间" value="{$upret.ltime}"  id="datepicker" onfocus="this.blur();">
                            <span class="input-group-addon"><i class="glyphicon glyphicon-calendar"></i></span>
                        </div>
                    </div>
                </div>

                <div class="form-group">
                    <label class="col-sm-3 control-label">返校时间 <span class="asterisk">*</span></label>
                    <div class="col-sm-9">
                        <!--<input type="date" name="btime" class="form-control" required  value="{$upret.btime}"/>-->
                        <div class="input-group">
                            <input type="text" class="form-control" name="btime" placeholder="yy-mm-dd 返校时间" value="{$upret.btime}" id="datepicker2" onfocus="this.blur();">
                            <span class="input-group-addon"><i class="glyphicon glyphicon-calendar"></i></span>
                        </div>
                    </div>
                </div>

            </div><!-- panel-body -->
            <div class="panel-footer">
                <div class="row">
                    <div class="col-sm-9 col-sm-offset-3">
                        <button class="btn btn-primary " type="submit">提交</button>
                        <button type="reset" class="btn btn-default">重新填写</button>
                    </div>
                </div>
            </div>

        </div><!-- panel -->
    </form>


</div>